GILBERT: Sensible GOP leaders should accept Obamacare cash

Radio commentator Rush Limbaugh, self-proclaimed spokesman for American conservatism, couldn't answer a listener's question concerning who would pay for health insurance for the unemployed and destitute under Obamacare.

He admitted he didn't know the specifics about how these situations would be handled. If he did know them, perhaps the facts of the situation might change his opinion.

Or maybe Limbaugh wouldn't let the facts get in the way of his opinion even if he knew them.

The realities all added up for Republican Michigan Gov. Rick Snyder, and that is why he is accepting federal funds to expand Medicaid eligibility to some 470,000 Michigan residents.

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What's incredulous is that Republican governors in 11 states say they will reject the money. It will be interesting to see how their hospitals, healthcare professionals and citizens react to that.

States can refuse the expansion outright or indefinitely postpone a decision. But if they ultimately want to take the deal, it makes sense to act now, the Associated Press noted.

Three years of full federal funding for newly eligible enrollees are only available from 2014 through 2016. The federal government will pick up at least 90 percent of the cost over the long haul. The match rate for existing Medicaid participants is 66 percent.

According to Kaiser Health News, Michigan would receive more than $14 billion from the federal government between now and 2019 and have to pick up just 5 percent of the cost of the program's expansion.

That's a huge infusion of cash into the state and it will undoubtedly create jobs in health-related fields, as well as providing coverage for needy individuals.

"I think it will save money and save lives," said State Rep. Gail Haines, a Republican from Lake Angelus who chairs the House Policy Committee.

She points out that the uninsured currently receive uncompensated care, usually in emergency rooms. Now it will be paid for.

"Emergency room care is the least cost-effective form of care," Haines said. Often people in such situations delay their care and, thus, need more when they finally have to go to the emergency room.

"If you think uncompensated care is not cost-shifted, you are mistaken," Haines said.

It ends up being passed on eventually to those who have insurance as hospitals raise prices on paying patients.

Snyder underscored the point.

For newly eligible Medicaid recipients, "this new coverage means having access to quality, preventative care. It means they'll be able to get routine checkups. And it means that they won't head to the emergency room as a last resort when they need to see a doctor."

The governor continued:

"What does it mean for our state? It's all about saving money by being smarter.

"When uninsured people go to the emergency room for non-emergency care -- instead of seeing a primary care doctor -- it costs hospitals millions each year in uncompensated costs. By expanding Medicaid, people will have access to primary care doctors, saving Michigan hospitals those uncompensated care costs.

"Job creators, too, will see savings with this law. Under the Affordable Care Act, they're required to either provide health care for their employees or pay a significant penalty. Many businesses have said they can't afford the costs -- that they'll have to shut their doors. By expanding Medicaid, we can provide an affordable option that will help businesses stay open while offering employees affordable healthcare."

Snyder said Michigan's uninsured population will drop by about 46 percent.

Americans for Limited Government President Bill Wilson excoriated Snyder for his decision.

"There is not enough revenue to pay for Medicaid expansion under Obamacare," Wilson said. "So it will be borrowed. Thanks to Gov. Snyder, taxpayers will be paying interest on Michigan's Medicaid expansion for posterity."

But Wilson is confusing an apple for an orange. He is saying that because the federal government has a problem, Michigan residents should charitably pass up the federal cash, shooting themselves in the foot along the way.

Does Wilson really think the money will go unspent if Michigan passes it up? If so, he has forgotten his high school civics instruction.

The National Journal noted that Jan Brewer, Arizona's feisty Republican governor, is better known for wagging her finger at President Obama than for linking arms with him.

"That's why Brewer's recent announcement that her state intends to join the expansion of Medicaid central to Obama's health care law may represent an important shift," The Journal reported. "If even Brewer, who has battled repeatedly with Obama, finds the case for expansion compelling, other Republican governors now resisting may also reconsider."

Loud-mouth Obamacare opponents like Florida Gov. Rick Scott and Texas Gov. Rick Perry are looking a gift horse in the mouth by rejecting the Medicaid funds.

The fight over Obamacare is over. It's time to make the best of it.

Glenn Gilbert is executive editor of The Oakland Press. Contact him at glenn.gilbert@oakpress.com or 248-745-4587. Follow him on Twitter @glenngilbert2.